Provider Demographics
NPI:1467545053
Name:GEHIN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GEHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 MINNEHAHA AVE
Mailing Address - Street 2:MC: 952
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3339
Mailing Address - Country:US
Mailing Address - Phone:651-325-7913
Mailing Address - Fax:
Practice Address - Street 1:671 VANDALIA ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1312
Practice Address - Country:US
Practice Address - Phone:651-698-2406
Practice Address - Fax:651-696-5544
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN140272-0363LW0102X
MN1375171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN770S7GEOtherBLUE CROSSS BLUE SHIELD
MN770S7GEOtherBLUE CROSSS BLUE SHIELD